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HRET Trustee Institute
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Lynn: Lead With Mission, Close With Accountability
Representatives of NJHA and many of its member hospitals traveled to Washington, D.C., in May to participate in the American Hospital Association's Annual Meeting and watch as New Jersey's AtlantiCare President and CEO George Lynn was officially sworn in as chairman of the AHA Board of Trustees.
At his investiture ceremony, Lynn delivered a remarkable speech that challenged healthcare providers to relate stories about the compassionate care they provide every day. Lynn said hospitals do not fare well with the public when they talk and act like big business. "There is something special about the work we do. I think of it in these terms…there is the work that we do, and there is the business that we are in."
Lynn pointed out that a paradox exists between the simplicity of the work and the mountains of paperwork and regulations involved in the everyday operations of a healthcare facility. "Contrast the simplicity of the work that we do with the complexity of the business aspect of our organizations – the morass of regulation, the mountains of paperwork, the intricacies of reimbursement and the layers of compliance and oversight."
Lynn recounted an exchange in which a New York Times reporter was asked why her paper reported so many healthcare stories in the business section. The reporter explained, "Because you act like businesses. When you behaved like local charities and focused on doing good for the community, we covered you in the local section. Somewhere along the way you changed."
Offered Lynn, "One key to managing this paradox is to make sure that everything we do, in the business that we are in, supports the work that we do for people – and not the other way around. Healthcare gets into trouble when we lose sight of what is important to the people we serve."
AHA's advocacy agenda for 2005 is rooted in the longstanding hospital mission of taking care of people, and it stands for everything that makes hospitals cornerstones of community care: protecting the healthcare safety net, improving care and increasing affordability and expanding coverage.
More specifically, the AHA advocacy agenda includes:
- Ensuring that government meets its fiscal responsibility to those who rely on Medicare and Medicaid for their care;
- Working with other organizations to develop solutions to the uninsured crisis;
- Strengthening the delivery of care while also strengthening the bond between hospitals and those they serve.
Lynn likened the mission to a picture frame, defining work boundaries and creating a context into which others who have a stake in healthcare can participate. "In the daily tug of war between the business we're in and the work that we do, always lead with the mission. Mission defines what we do. It makes us credible."
Lynn suggested that once everyone begins to lead with a mission, quality, safety and service must follow. "Quality, safety and service begins to define our hospitals' unique role and value. Critics of our system say it is disjointed, incremental, overly procedural in nature, unequal in terms of access, too expensive and bewildering to those who have to use it. Yet, almost everyone agrees that we have never had more capability to cure and care than we do today."
Finally, accountability must exist even though it increases a hospital's exposure to the risk of litigation. Stated Lynn, "We need help from government to find ways that hospitals and other health providers can share and publish treatment and outcomes data and, in doing so, improve care delivery processes. We also need to increase our accountability to the communities we serve.
"Let's lead with mission, follow with quality, safety and service and close with accountability. Let's find our voice together and let that voice be firm and confident in its advocacy for the patients we care for and the communities we serve," concluded Lynn.
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Issues Briefing from the Pages of NJHA's NewsLink
State budget talks are in the homestretch, with the July 1 start of the new state fiscal year fast approaching. NJHA continues to work with key lawmakers to restore $51 million in charity care cuts that are part of Acting Gov. Richard Codey's proposed spending plan... NJHA's ICU Collaborative, an effort by the NJHA Quality Institute to improve quality and efficiency in the state's intensive care units, has achieved impressive early results. After six months of data collection, the 24 participating hospitals and health systems have reduced the incidence of catheter-related bloodstream infection and ventilator-associated pneumonia by an average of one-third. The average ICU length of stay has also declined... Medicare's controversial 75 percent rule, which imposes strict new limits on the numbers and types of patients deemed eligible for inpatient rehabilitation care, is set to take effect July 1. Healthcare advocates and New Jersey lawmakers worry that the change will sharply limit patients' options in rehabilitation care. Advocacy efforts to delay the rule change and study its impact on patients continue... A congressional committee recently held a hearing challenging the tax-exempt status of the nation's nonprofit hospitals. Hospital advocates were on hand to educate lawmakers about the billions of dollars in uncompensated care that hospitals deliver to the poor and uninsured.
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Update from the NJHA Council on Hospital Governance
Congratulations to Gordon N. Litwin, Esq., of Meridian Health and Allan J. Clelland of Carrier Clinic who were honored with Trustee of the Year Awards during the NJHA Annual Meeting in May. The two honorees were recognized for their longtime commitment to their hospitals and their communities. For more information on these prestigious honors, visit the Trustee Institute Web site at http://www.njha.com/trustee/html/trusteenews.aspx.
In other trustee news, regional meetings were held this spring at NJHA, St. Joseph's Regional Medical Center and Kennedy Health System. The main educational focus of the meetings was corporate compliance. While already a part of trustee responsibility, the government issued new rules in the January 2005 Federal Register with more direction and requirements.
Fall regional meetings are now being scheduled, and the education program will include a presentation by Cari Miller from the PRONJ, The Healthcare Quality Improvement Organization of New Jersey. Her presentation will include information on the 8th Scope of Work as well as the role of the quality improvement organizations with hospitals and Medicare.
The Council on Hospital Governance also seeks suggestions for education programs for all trustees. Please send your suggestions to NJHA's Sally Roslow on topics of concern or interest. For further information on any of these issues, call Sally Roslow, vice president of trustee relations, at 609-275-4224 or sroslow@njha.com.
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